Tips and tricks for a successful Emergency Department visit

In the last post we discussed why Migraineurs are often mis-labeled as DRUG SEEKERS.

Because a Migraine diagnosis is often used as a means for true drug seekers to obtain prescription medications, emergency physicians are often quite gun-shy about treating any chronic pain patients, including and especially Migraineurs.

They are often not well-versed themselves about appropriate Migraine diagnosis or treatment options such as abortives, and assume patients have entered their emergency department looking only for pain medication.

Additionally, true pain patients and Migraineurs are also gun-shy, often assuming that unless they overstate their pain it won’t be appropriately treated.

Having to admit defeat to our Migraine and landing in the emergency department (ED) is a scary enough proposition, but add to that the pain and helplessness Migraineurs often feel when they’ve become this desperate, combined with physician distrust (some of it earned), and we can end up with quite a disastrous result.

As Migraineurs, it is vital that we are taken seriously and believed when we visit the emergency room (ER). There are effective ways to accomplish this, and things that we can do to really hurt ourselves without realizing it.

Over the years I’ve developed some helpful strategies for emergency room visits:

  • The ER is only for times when you can’t get to your regular doctor, or you need additional abortive treatment that is not available elsewhere. Do go to the ER if you are having the “worst headache of your life” or have symptoms resembling stroke or other life threatening emergency medical condition. If you are in the ED waiting room playing video games or talking animatedly with a friend, you will not (and should not) be taken seriously.
  • Make sure you are seeing a local headache specialist. When ED staff know this, they are often more likely to treat you appropriately and effectively.
  • Take someone with you to act as your advocate. They can speak for you when you are unable to speak for yourself. ED staff are much less likely to treat you negatively when there is someone else in the room.
  • Ask your physician for an emergency room prescription for Migraine abortive treatment, followed only then by pain treatment should you need to visit the ED. You can carry this with you to the ED and most often doctors will follow the suggested protocol.
  • Do not overstate your pain level, but express yourself in easy to understand terms such as “I’ve never ever had a Migraine this bad before. It’s a 10”
  • Upon speaking with the ED staff, make sure they understand that you want a Migraine abortive, not just pain medication. Be educated in your abortive choices (they may not be) so if they ask you what you want to try, you can give them a knowledgeable answer.
  • Dress the part. If you look like a drug seeker when you walk in the door, you will most likely be perceived as one. Makeup is not necessary, and nobody cares if your hair is a mess or your breath is smelly, but at least be clean and wear clean and modest, colored (not black) clothing. Unfortunately, tattoos and body piercings are often disrespected in this setting, so if you’ve got them, try to cover or remove them. Be sure your advocate is at least similarly presented.
  • Treat ED staff with respect. Saying Please and Thank You can go a long way.
  • Expect respect, but understand that fighting and acting hysterical will only hurt you with an already distrusting physician.
This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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